Individual
JAN K. SIEBERSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
745 BUENA VISTA DR, LANDER, WY 82520-3431
(307) 332-2941
(307) 332-1920
Mailing address
745 BUENA VISTA DR, LANDER, WY 82520-3431
(307) 332-2941
(307) 332-1920
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
8076A
WY
207VG0400X
Gynecology Physician
92-345
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25802
PRES
NM
01
—
5275478
LOVELACE
NM
05
—
F6662
—
NM
01
—
NM009818
BCBS
NM
Enumeration date
06/01/2005
Last updated
06/15/2015
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